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Background/Objectives: The broad spectrum of clinical manifestations from SARS-COV-2 infection and observed risk factors for severe disease highlight the importance of understanding molecular mechanisms underlying SARS-CoV-2 associated disease pathogenesis. Research studies have identified a large number of host proteins that play roles in viral entry, innate immune response, or immune signalling during infection. The ability to interrogate subsets of these genes simultaneously within SARSCOV-2 infected samples is critical to understanding how their expression contribute to phenotypic variability of the disease caused by the pathogen. Method(s): 30 Nasopharyngeal swab were obtained and included SARS-CoV-2 infected and control samples. RNA was extracted, reverse transcribed and loaded onto flexible TaqMan array panels designed specifically for targeting the most cited genes related to SARS-COV-2 entry and restriction factors as well as cytokines, chemokines, and growth factors involved in the pathogenesis. Result(s): Our data indicated that not only were the levels of several of these host factors differentially modulated between the two study groups, but also that SARS-CoV-2 infected subjects presented with greater frequency of several important inflammatory cytokines and chemokines such as CCL2, CCL3, IFNG, entry receptors such as ACE2, TMRPS11A, and host restriction factors including LY6E and ZBP1. Conclusion(s): TaqMan array plates provide a fast, midthroughput solution to determine the levels of several virus and host-associated factors in various cell types and add to our understanding of how the pathogenesis may vary depending on gender, age, infection site etc.
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The COVID-19 pandemic has had a significant impact on human behaviors and how it influenced peoples' interests in cultural products is an unsolved problem. While prior studies mostly adopt subjective surveys to find an answer, these methods are always suffering from high cost, limited size, and subjective bias. Inspired by the rich user-oriented data over the Internet, this work explores the possibility to leverage users' search logs to reflect humans' underlying cultural product interests. To further examine how the COVID-19 mobility policy might influence cultural interest changes, we propose a new regression discontinuity design that has the additional potential to predict the recovery phase of peoples' cultural product interests. By analyzing the 1592 search interest time series in 6 countries, we found different patterns of change in interest in movies, music, and art during the COVID-19 pandemic, but a clear overall incremental increase. Across the six countries we studied, we found that changes in interest in cultural products were found to be strongly correlated with mobility and that as mobility declined, interest in movies, music, and art increased by an average of 35, 27 and 20, respectively, with these changes lasting at least eight weeks. © 2023 ACM.
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In this study, graduate "programs of strategic emphasis” at a state university in Florida, USA during the spring semesters of 2019, 2020, 2021, and 2022 were examined. The students' application, enrollment, performance, and graduation data for the four semesters were collected and analyzed. Due to COVID-19, all courses had to be delivered purely online in the latter spring semester of 2020. Facing various challenges and uncertainties, the Graduate School worked with all programs to update their programs and remove admission barriers, including graduate record examination (GRE) requirements. After the onset of the pandemic, the number of applicants increased (p < 0.001), the number of students enrolled increased (p < 0.001), and the yield rate of enrolled new students compared to applicants decreased (p < 0.001). Despite the removal of admission barriers, the undergraduate grade point averages (GPA) of new applicants did not decrease (p = 0.500), graduate GPA in the first semester increased (p < 0.001), and overall graduate GPA increased (p < 0.001). Finally, graduation rates increased after the onset of the pandemic (p < 0.001). This study demonstrates that despite challenges due to the pandemic, removal of admission barriers did not adversely affect student outcomes. © 2023 by the authors.
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This study aims to investigate the effect of sports regulation on the psychological state of English students. The author administered the experimental method and SCL-90 symptom assessment to 461 students in a regional normal school. By gathering data from students at various stages of the experiment, psychological trends and emotional shifts were identified promptly to improve experimental outcomes. The questionnaire data and test results were processed and analyzed using SPSS and other statistical software. The study results indicate that the sports intervention is viable and effective in boosting pupils' mental health. To effectively protect students' physical and mental health development, colleges and universities should strengthen the publicity and construction work in this area, let students realize the true significance of sports, and encourage students to engage in sports and form healthy sports habits actively. In addition, it provides techniques and recommendations for enhancing mental health education to enhance the mental health of students at this school effectively.
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OBJECTIVES: COVID-19 has strained the household finances of many Americans who are already experiencing increasing health care expenses. Concerns about the cost of care may deter patients from seeking even urgent care from the emergency department (ED). This study examines predictors of older Americans' concerns about ED visit costs and how cost concerns may have influenced their ED use in the early stages of the pandemic.STUDY DESIGN: This was a cross-sectional survey study using a nationally representative sample of US adults aged 50 to 80 years (N = 2074) in June 2020.METHODS: Multivariate logistic regressions assessed the relationships of sociodemographic, insurance, and health factors with cost concerns for ED care.RESULTS: Of the respondents, 80% were concerned (45% very, 35% somewhat) about costs of an ED visit and 18% were not confident in their ability to afford an ED visit. Of the entire sample, 7% had avoided ED care because of cost concerns in the past 2 years. Of those who may have needed ED care, 22% had avoided care. Predictors of cost-related ED avoidance included being aged 50 to 54 years (adjusted odds ratio [AOR], 4.57;95% CI, 1.44-14.54), being uninsured (AOR, 2.93;95% CI, 1.35-6.52), having poor or fair mental health (AOR, 2.82;95% CI, 1.62-4.89), and having an annual household income of less than $30,000 (AOR, 2.30;95% CI, 1.19-4.46).CONCLUSIONS: During the early COVID-19 pandemic, most older US adults expressed concerns about the financial impact of ED use. Further research should examine how insurance design could alleviate the perceived financial burden of ED use and prevent cost-related care avoidance, especially for those at higher risk in future pandemic surges.Am J Manag Care. 2023;29(4):204-208. doi:10.37765/ajmc.2023.89282
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The emergence of the Covid-19 pandemic has drawn great attention to vulnerable people affected by major diseases. Among them, Alzheimer's disease (AD) is the most prevalent disease. However, a long-standing challenge is to achieve early diagnosis of AD by detecting biomarkers such as amyloid beta (Aβ42), thus avoiding the labor of specialized hospital personnel and the high cost of imaging examinations using positron emission tomography. In this paper, we report a straightforward approach to realize a non-invasive lab-around fiber (LaF) optical sensor for AD biomarker detection, which is based on a tilted fiber Bragg grating (TFBG) combined with a nanoscale metallic thin film. We successfully demonstrated the detection of Aβ42 in complex biological matrices with a detection limit of 5 pg/mL. Therefore, our TFBG-SPR biosensor platform enables large-scale early disease screening and has great potential for clinical applications in early AD diagnosis. © 2022 IEEE.
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Introduction: CARTITUDE-2 (NCT04133636) is a phase 2, multicohort study evaluating cilta-cel, an anti-BCMA CAR-T therapy, in several multiple myeloma (MM) patient (pt) populations. Objective(s): To report updated results with longer follow-up on cohort C pts with previous exposure to a non-cellular anti- BCMA immunotherapy. Method(s): Cohort C pts had progressive MM after treatment (tx) with a proteasome inhibitor, immunomodulatory drug, anti-CD38 antibody, and non-cellular BCMA-targeting agent. A single cilta-cel infusion (target dose 0.75x106 CAR+ viable T cells/kg) was administered 5-7 days post lymphodepletion. Primary endpoint was minimal residual disease (MRD) negativity at 10-5. Secondary endpoints included overall response rate (ORR), duration of response (DOR), and adverse events (AEs). Result(s): As of June 1, 2022, 20 pts (13 ADC exposed;7 BsAb exposed) were treated with cilta-cel;4 pts did not receive cilta-cel due to either low cellular yield (n=2, 1 in each group) or death due to progressive disease (PD) prior to dosing (n=2, 1 in each group) and 6 pts received anti-BCMA tx as their last line of therapy (n=4 ADC, n=2 BsAb). During prior anti-BCMA tx, best responses included VGPR (ADC: 2 pts;BsAb: 1 pt), sCR (ADC: 1 pt), and CR (BsAb: 1 pt);the rest had best response of stable disease or PD (1 pt not evaluable). Baseline characteristics are presented in Figure 1A. Median time from last anti- BCMA agent to cilta-cel infusion was 195 d;median administered dose of cilta-cel was 0.65x106 CAR+ viable T cells/kg. At a median follow-up of 18.0 mo, 7/10 evaluable pts (70%) were MRD negative at 10-5 (ADC: 5/7 [71.4%], BsAb: 2/3 [66.7%]). ORR: full cohort, 60%;ADC, 61.5%;BsAb, 57.1% (Figure 1B). Median DOR: full cohort, 12.8 mo;ADC, 12.8 mo;BsAb, 8.2 mo. Median PFS: full cohort, 9.1 mo;ADC, 9.5 mo;BsAb, 5.3 mo. Cilta-cel responders had a shorter median duration of last anti- BCMA agent exposure (29.5 d) compared with non-responders (63.5 d). Responders also had a longer median time from last anti-BCMA tx exposure to apheresis (161.0 d) than non-responders (56.5 d). Most common AEs were hematologic. CRS: n=12 (60%;all Gr1/2), median time to onset 7.5 d, median duration 6.0 d. ICANS: n=4 (20%, 2 Gr3/4), median time to onset 9.0 d, median duration 7.0 d. No patient had movement or neurocognitive tx emergent AE/parkinsonism. There were 12 deaths (PD: 8;COVID-19 pneumonia: 2 [not tx related];subarachnoid hemorrhage: 1 [not tx related];C. difficile colitis: 1 [tx related]). (Figure Presented)(Figure Presented)Conclusions: Pts with heavily pretreated MM and previous exposure to a non-cellular anti-BCMA therapy had favorable responses to cilta-cel. However, depth and DOR appear lower than that seen in anti-BCMA-naive pts treated with cilta-cel (at 27.7 mo, median DOR was not reached in heavily pre-treated but anti-BCMA naive CARTITUDE-1 pts). These data may inform tx plans, including sequencing and washout period between BCMA-targeting agentsCopyright © 2023 American Society for Transplantation and Cellular Therapy
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Background Taletrectinib is a potent, next-generation, CNS-active, ROS1 tyrosine kinase inhibitor (TKI) with selectivity over TRKB. In previous reports from TRUST-I, taletrectinib showed meaningful clinical efficacy and was well tolerated in pts with ROS1+ NSCLC (n = 109) regardless of crizotinib (CRZ) pretreatment status. We report updated efficacy and safety data with ~1.5 yr follow-up. Methods TRUST-I is a multicenter, open-label, single-arm study with two cohorts: ROS1 TKI-naive and CRZ-pretreated. Pts in both cohorts received taletrectinib 600 mg QD. Key study endpoints included IRC-confirmed ORR (cORR), DoR, disease control rate (DCR), PFS, and safety. A pooled analysis of ORR, PFS, and safety including pts from additional clinical trials was also conducted. Results In the 109 pts from TRUST-I (enrolled prior to Feb 2022) the median follow-up was 18.0 mo in TKI-naive (n = 67) and 16.9 mo in CRZ-pretreated pts (n = 42). cORR was 92.5% in TKI-naive and 52.6% in CRZ-pretreated pts (table). Median DoR (mDoR) and mPFS were not reached. Intracranial-ORR was 91.6%;ORR in pts with G2032R was 80.0%. In a pooled analysis with phase I studies, ORR was 89.5% and 50.0% for TKI-naive and CRZ-pretreated pts, respectively;mPFS was 33.2 mo and 9.8 mo. In 178 pts treated at 600 mg QD, treatment-emergent adverse events (TEAEs) were 92.7%;most (64.0%) were grade 1-2. The most common TEAEs were increased AST (60.7%), increased ALT (55.6%), and diarrhea (55.6%). Neurological TEAEs (dizziness, 18.5%;dysgeusia, 12.4%) and discontinuations due to TEAEs (3.4%) were low. Further updated results will be presented. [Formula presented] Conclusions With additional follow-up, taletrectinib continued to demonstrate meaningful efficacy outcomes including high response rates, prolonged PFS, robust intracranial activity, activity against G2032R, and tolerable safety with low incidence of neurological AEs. Clinical trial identification NCT04395677. Editorial acknowledgement Medical writing and editorial assistance were provided by Arpita Kulshrestha of Peloton Advantage, LLC, an OPEN Health company, and funded by AnHeart Therapeutics, Inc Legal entity responsible for the study AnHeart Therapeutics, Inc. Funding AnHeart Therapeutics, Inc. Disclosure S. He: Financial Interests, Personal, Other, Employment: AnHeart Therapeutics. T. Seto: Financial Interests, Institutional, Research Grant: AbbVie, Chugai Pharmaceutical, Daiichi Sankyo, Eli Lilly Japan, Kissei Pharmaceutical, MSD, Novartis Pharma, Pfizer Japan, Takeda Pharmaceutical;Financial Interests, Personal, Other, Employment: Precision Medicine Asia;Financial Interests, Personal, Speaker's Bureau, Honoraria for lectures: AstraZeneca, Bristol-Myers Squibb, Chugai Pharmaceutical, Covidien Japan, Daiichi Sankyo, Eli Lilly Japan, Kyowa Hakko Kirin, MSD, Mochida Pharmaceutical, Nippon Boehringer Ingelheim, Novartis Pharma, Ono Pharmaceutical, Pfizer Japan, Taiho Pharmaceutical, Takeda Pharmaceutical, Towa Pharmaceutical. C. Zhou: Financial Interests, Personal, Other, Consulting fees: Innovent Biologics Qilu, Hengrui, TopAlliance Biosciences Inc;Financial Interests, Personal, Speaker's Bureau, Payment or honoraria: Eli Lilly China, Sanofi, BI, Roche, MSD, Qilu, Hengrui, Innovent Biologics, C-Stone LUYE Pharma, TopAlliance Biosciences Inc, Amoy Diagnositics, AnHeart. All other authors have declared no conflicts of interest.Copyright © 2023 International Association for the Study of Lung Cancer. Published by Elsevier Inc.
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The purpose of this article is to discuss the purchasing behavior (PB), influencing factors, and personal factors of Chinese consumers through literature review, questionnaire survey, and research results. The frequency and amount of purchasing behavior (FPB and APB) are studied in the consumption behavior. In the influencing factors, channel cognitions (CC), product cognitions (PC), and the influence of personal factors on consumer consumption behavior of fresh agricultural products. The FPB and APB are significantly and positively correlated with the CC, PC, and advantage cognition (AC). The FPB and APB are significantly and negatively correlated with disadvantage cognitions (DC). People's CC, PC, and DC significantly affect their FPB and APB. © 2022 IEEE.
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It is well and widely known that sample pooling could provide an effective and efficient way for fast coronavirus testing among massive asymptomatic individuals. The method of multi-level acceleration for asymptomatic COVID-19 screening has been introduced, and for one and two levels, the optimal group sizes have been obtained. However, there are still multiple challenges. First, it is not clear how to find the optimal group sizes for three or more levels. Second, there is lack of closed-form expressions for the optimal group sizes for two or more levels. Third, it is not clear how to determine the optimal number of levels. And last, it is not known what the maximum achievable speedup is. The motivation of this paper is to address all the above challenges. The optimization of a hierarchical pooling strategy includes its number of levels and the group size of each level. In this paper, based on multi-variable optimization and Taylor approximation, we are able to derive closed-form expressions for the optimal number of levels (Formula presented.), the optimal group sizes (Formula presented.), (Formula presented.),…, (Formula presented.), and the maximum possible speedup of a hierarchical pooling strategy of (Formula presented.), where (Formula presented.) is the fraction of infected people. The above speedup is nearly a linear function of the reciprocal of (Formula presented.), in the sense that it is asymptotically greater than any sub-linear function (Formula presented.) of the reciprocal of (Formula presented.) for any small (Formula presented.). Using the results in this paper, we can quickly and easily predict the performance of an optimal hierarchical pooling strategy. For instance, if the fraction of infected people is 0.0001, an 8-level hierarchical pooling strategy can achieve speedup of nearly 400. © 2023 Informa UK Limited, trading as Taylor & Francis Group.
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The outbreak of COVID-19 at the end of 2019 has posed an enormous threat to people's physical and psychological health, especially those who are infected during the epidemic. Understanding how the infected people behaved during the pandemic and whether long-term effects are exerted even after they were cured is essential for guiding them to conduct a more comprehensive recovery. Large scale crowd-sourced data provides a chance to investigate their behavior patterns. In this paper, we explore the possible differences in mobility patterns between the infected and the uninfected, relying on a large volume of crowd -sourced location data contributed by smartphone users consisting of 11,414 infected cases and 12,793 uninfected people between Jun. 1, 2019 and Dec 31, 2020 in Wuhan, China. We characterize mobility distinctions of the two groups by introducing five mobility indicators that accurately capture spatio-temporal patterns of human mobility. We reveal that the infected kept higher mobility level during the pandemic. Moreover, the COVID-19 caused lower recovery efficiency on mobility of the infected, including later recovery time, lower speed and worse status. © 2022 IEEE.
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Since 2020, with the global spread of major respiratory infectious diseases, such as COVID–19, the demand and consumption of personal protective equipment, such as masks, have increased dramatically worldwide. The environmental pollution caused by numerous waste disposable face masks has gradually attracted people's attention. In this study, the mechanical properties of mask–chip–reinforced soil are evaluated from a new perspective, through the uniaxial, biaxial, conventional triaxial, and true triaxial compression tests on reshaped sandy soil samples mixed with different contents of mask chips. The experimental results show that the mechanical properties of the sandy soil can be improved by the mask chips. With the proper content of mask chips, the failure strength is substantially improved, and the failure of soil is delayed. Meanwhile, the strength and stiffness are significantly affected by the stress path and the content of mask chips, even if the soil samples with the same mask–chip content can also show different mechanical properties under different stress paths. Additionally, the mechanical properties of soil are not necessarily improved constantly with the increasing content of mask chips. The failure strength of sandy soil samples under conventional and true triaxial stress paths decreases when the mass content of mask chips exceeds 0.3% and 0.5%, respectively. This study confirms the potential of mask chips applied to subgrade, slope, and other engineering construction fields in a sustainable way. © 2023 by the authors.
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COVID-19 , Esotropia , Myopia , Humans , Esotropia/etiology , COVID-19/complications , Pandemics , Acute Disease , Oculomotor MusclesABSTRACT
Covid-19 has become a world pandemic for years. With the appearance of mutations, immune escape has become a problem, reducing the effectiveness of vaccines and antibodies. To reveal the mechanism of immune escape, we analyze the geometrical properties of the receptor-binding domain in the SARS-CoV-2 spike protein, which plays a vital role in the immune reaction. Several important variants are taken as examples, and the wild type model is prepared as a reference. The computational method is applied to simulate the behaviors of the models, and alpha shape algorithm is employed to extract geometrical data of the protein surface. Average moving distance of the surface atoms is used to quantify their activity. Our results show that the mutations changed the properties of the protein. The variants have different distributions of active sites, which may change the specific antigenicity and influence the binding abilities of drugs and antibodies. This study explains the mechanism of immune escape of SARS-CoV-2, and provides a geometrical method to find potential new target sites for the design of drugs and vaccines. © 2022 IEEE.
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A clinical trial is a key step in the process of pharmaceutical research and development (R & D). It is a key indicator of the innovative potential of the pharmaceutical industry. ClinicalTrials.gov shows that the average annual growth rate of the total number of clinical trials globally in the past decade (2012-2021) was 20.7%, mainly distributed in Europe and the United States, and the total number of clinical trials registered in China accounted for 6% of the world. According to the statistics of IQVIA Institute for Human Data Science, the global proportion of early-stage R & D pipelines from China-headquartered companies increased from 1% in 2005 to 12% in 2020, which was still far behind that of European and American companies. Among 871 new active substances approved for marketing globally in the past two decades, 522 were for marketing in China, with the high number driven by regulatory acceleration mechanisms from National Medical Products Administration, such as breakthrough and orphan designations and priority reviews. Considering the gap in clinical research strength between China and developed countries such as Europe and the United States, the clinical trial research capacity and level should be improved to assist China in the R & D of innovative drugs. According to the Registration and Information Disclosure Platform for Drug Clinical Studies and the clinical trial institution filing management information platform in China, in the last five years (2017-2021), the average annual growth rates of the total number of new drug clinical trial registration and clinical trial units in China reached 26.9% and 12.6%, respectively. However, clinical trial resources are mainly concentrated in major institutions, municipalities, or provincial capital cities in the eastern and central regions of China, with distributions becoming increasingly polarised. Under the background of China's new medical reforms, the strategic direction of national political support is to motivate equitable access to high-quality clinical trial resources and cross-regional collaborative development of medical institutions by means of medical unions, national clinical medical research centres, Chinese national major projects for new drug innovation and so on. In the context of this background, clinical trial research unions (CTRUs) have been built in China. A CTRU is defined as a consortium formed by medical institutions, sponsors and third-party service institutions of various levels and functions, led by a national clinical medical research centre or clinical trial medical institutions undertaking major national science and technology projects or supporting projects of national key R & D plans, radiating and driving the improvement of clinical trial research capacity in multiple regions. CTRUs develop a multi-level clinical research centre system and collaborative network by vertically and horizontally combining multi-level medical institutions, sponsors and third-party service institutions. All participants of CTRUs are crucial. The leading clinical trial research medical institution, as the core, is responsible for establishing institutional system standards in CTRUs, designing and leading high-quality multi-centre clinical trials, central ethics and personality training. The major clinical trial research medical institutions are responsible for implementing high-quality, multi-centre, complex and high-risk clinical trials. The other member institutions are responsible for implementing basic clinical trials. The sponsors, contract research organizations (CROs), site management organizations (SMOs) and other enterprises are responsible for funding, supporting and promoting the construction of a clinical trial centre system and collaborative network. The specific construction contents of CTRUs include building a clinical trial research resource sharing platform, homogenising clinical trial quality management, constructing a rapid clinical trial process platform, diversified multi-level and multi-form talent training, information intercon ection, deepening strategic cooperation and designing and leading high-level trials. CTRUs have established the selection criteria and assessment exit mechanism and conducted work performance assessments from the dimensions of organisation and implementation, division of labour and cooperation, the connection of clinical trial resources from top to bottom, efficiency and benefit and sustainable development to ensure their good and sustainable development. Through CTRUs, we can achieve high-quality clinical trial resource sharing, improve the clinical trial research capability of member institutions, cultivate high-level skills, such as principal investigators (PIs), sub-investigators, institutional managers and clinical research coordinators (CRCs), and promote the development of clinical trials, economically and with high-quality. Through the trial operation with one member of CTRUs, it was found that the key points should be strengthened in deepening resource sharing, implementing central ethics review, interconnecting information platforms and leading high-quality clinical trials. The construction of CTRUs is an effective means for China's clinical trial research to solve the current problems and change from a `follow-on pattern' to leading high-level and high-quality international multi-centre trials. However, the construction of CTRUs is a complex systematic project. In addition to performing an excellent job in the top-level design and overall planning, CTRUs' specific implementation process and measures need to be continuously explored in the practice process.
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Middle East respiratory syndrome coronavirus (MERS-CoV) infection in humans has a high mortality of >30%. Dromedaries are the reservoir of MERS-CoV and the main source of human infections. However, MERS-CoV infections in dromedaries are usually subclinical. Rapid diagnosis of MERS-CoV infection in these animals is important in preventing camel-to-human transmission of the virus. The possible cross-reactivity of a previously reported rapid nucleocapsid protein-based antigen detection assay for MERS-CoV was examined with different CoVs, including Tylonycteris bat CoV HKU4, dromedary camel CoV UAE-HKU23, human CoV-229E, human CoV-OC43, severe acute respiratory syndrome CoV-2 and rabbit CoV HKU14, where none of them showed false-positive results. The assay was further validated using quantitative real-time reverse transcription-polymerase chain reaction-confirmed MERS-CoV-positive and MERS-CoV-negative dromedary nasal samples collected in Dubai, the United Arab Emirates, which showed that the rapid antigen detection assay has a specificity of 100% and sensitivity of 91.7%.
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Background. Substantial changes in access and delivery of primary HIV care occurred during the COVID-19 pandemic. To assess how care access changed during the COVID-19 pandemic, we estimated ED use among PWH in care 2017-2021 in the southeastern US. Methods. For each calendar year, among PWH in care in the UNC CFAR HIV Clinical Cohort (defined as having a clinic visit in the current or prior year), we estimated the percent of patients with >= 1 ED visit in a given year, overall and by age, gender, race/ethnicity, HIV viral load (VL), and CD4 count. We estimated risk ratios (RRs) comparing patient characteristics and years 2020-2021 vs. 2017-2019, using Poisson regression with generalized estimating equations to account for repeated measures. Results. Among 2129 PWH in care 2017-2021 (N=1700-1800 in each year), 57% identified as Black, 31% White, 8% Hispanic, 26% women, with median age of 47 years (IQR 35-55). During the study period, there were 3645 ED visits over 8813 person-years, a rate of 41.4 ED visits-per 100 person-years(95% CI 36.8-46.5) per 100 person-years. The 845 PWHwith at least one ED visit during the study period contributed amedian of 2 visits each (IQR1-5). The unadjusted probability of having>=1 EDvisit in a given year was higher among women vs. men (RR=1.14, 95% CI 0.99-1.32), Black vs. White PWH (1.31, 1.13-1.52), with VL >= 40 copies/mL (1.40, 1.20-1.64), and with CD4 < 200 (1.66, 1.32-2.09) or 200-349 (1.50, 1.25-1.79) vs. >= 500 cells/muL;age was not associated with ED use. Comparedwith 2017-2019, the annual probability of having>=1 EDvisit was lower in 2020-2021, with RRs of 0.83 (95% CI 0.76-0.90) in unadjusted analyses and 0.80 (95%CI 0.71-0.90) after adjusting for demographics, VL, and CD4. There was also a significant unadjusted decrease for 2020-2021 vs. 2017-2019 among women, men, PWH who were Black, White, < 40 or 50-59 years old, and with CD4 >500 (Fig. B-F, all P< 0.05). Conclusion. Among PWH in HIV care, ED use was higher among women, Black PWH, and PWH with poorly controlled HIV. ED use decreased 2020-2021 in most groups, indicating that PWH during the COVID-19 pandemic may be delaying seeking care for acute conditions, or accessing care in other ways. Work is ongoing to characterize reasons for ED visits across calendar years and examine the impact of reduced ED utilization among PWH.
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Social isolation and loneliness are related but distinct constructs. A number of studies have examined these two constructs separately;however, the combined and interactive effects of social isolation and loneliness on health outcomes have rarely been studied. Using the most recent data of the Health and Retirement Study (HRS 2020) collected during the pandemic, this study aimed to explore the latent classes of social isolation and loneliness among adults aged 60 and older (N=3,486) and to examine the associated psychological well-being. Social isolation was measured by five indicators, including living alone, no membership in any organizations, and less than once a month contact with children, relatives, and friends. Loneliness was measured by the 3-item UCLA scale. Four classes were identified by the Latent Class Analysis (LCA): neither isolated nor lonely (class 1, 35%), living alone and lonely (class 2, 25%), no social participation and lonely (class 3, 18%), and highly isolated and lonely (class 4, 23%). The results of multivariate regression indicated that compared to respondents who were neither isolated nor lonely, those who were in the class of living alone and lonely and the class of highly isolated and lonely had more depressive symptoms, stress, anxiety, worry, loneliness during the pandemic. The latent class of no social participation and lonely was associated with more depressive symptoms and covid-related stress. This study emphasizes the importance of specialized intervention strategies targeting the unique needs of older adults with different experiences of social isolation and loneliness.
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This study aimed to systematically review and depict the current studies of traditional Chinese medicine for the mental health of patients with coronavirus disease 2019 (COVID-19).Methods:: A scoping review was conducted by searching PubMed, Web of Science, CNKI, Wanfang database, VIP database, and SinoMed, with the retrieval time being from the establishment of the database to April 18, 2022. The basic information of the included studies, objective, design, types of patients, interventions, outcomes, etc., was reviewed and summarized narratively. Methodological quality was assessed using the Cochrane Risk of Bias assessment tool, the methodological index for non-randomized studies or the Newcastle–Ottawa scale. Results:: We identified 30 traditional Chinese medicine (TCM) studies from six databases. Among them, finished randomized controlled trials (n = 16) accounted for most of the studies, followed by single-arm studies (n = 9). In terms of study theme, 20 studies defined the mental health of patients with COVID-19 as the research theme. Psychological assessment was included in the inclusion criteria (performed before participation) of nine studies, whereas the other studies only mentioned the mental outcomes. TCM interventions included TCM exercises (Yijinjing, Baduanjin, Liuzijue, Taichi), acupoint stimulation (auricular and body points), moxibustion, decoction, or granules based on TCM syndrome differentiation, decoction, or granules with fixed formulae (Baidu Jieduan granules, Xuanfei Baidu decoction, and Qingfei Paidu decoction), Chinese patent medicine (Jinhua Qinggan granules), TCM psychological therapy (TCM ideological therapy, TCM five-tone therapy, and TCM psychological sand table), and TCM nursing (dialectical care, dialectical diet, and psychological counseling). Anxiety and depression were the main outcomes evaluated in regard to mental health in patients with COVID-19. The limitations of methodological quality were predominantly from follow-up, blinding, and registration. Positive results were reported by 27 studies (90%, n = 30). Conclusion:: We summarized the existing literature about the impact of TCM on mental health in patients with COVID-19. The number of studies evaluating the impact of TCM on mental health is encouraging, but overall methodological quality was low. Several TCM interventions warrant further evaluation, particularly among populations outside of China, for the purpose of establishing supporting evidence. More importantly, research with stronger methodological quality needs to be developed. Graphical :: http://links.lww.com/AHM/A36.